<span style="font-size: 12px;"> <span style="color: rgb(20, 24, 35);">Avrasya Hospital’in başarılı doktorlarından Dr.Nurcan Dalan Avrasya Hospital’in konferans salonunda Kadın Hastalıkları ve gebelik hakkında bir seminer verdi.Biz de İstanbul Times Yayın Grubu olarak semineri sizler için takip ettik.</span> </span> <div><span style="font-size: 12px;"> </span></div> <div><strong><span style="font-size: 12px;"><span style="background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">İstanbul Times Haber Merkezi-Sibel Gülersöyler</span></span></strong></div> <div><span style="font-size: 12px;"> </span></div> <div><span style="font-size: 12px;"><span style="color: rgb(20, 24, 35); background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">Türkiye’de ve dünyada en önemli gelişmişlik düzeylerinden birisi de anne ve bebek ölümlerinin azlığıdır. Dünyada her yıl 400.000 civarında anne ölümü olmaktadır.</span></span></div> <div><span style="font-size: 12px;"> </span></div> <div><span style="color: rgb(255, 0, 0);"><strong><span style="font-size: 12px;"><span style="background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">Türkiye de ise bu oran;</span></span></strong></span></div> <div><span style="font-size: 12px;"> </span></div> <div><span style="font-size: 12px;"><span style="color: rgb(20, 24, 35); background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">2002 yılında anne ölüm oranı yüzbin canlı doğumda 64 iken, </span></span></div> <div><span style="font-size: 12px;"><span style="color: rgb(20, 24, 35); background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">2005 yılında yapılan 28,5’a,</span></span></div> <div><span style="font-size: 12px;"><span style="color: rgb(20, 24, 35); background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">2012 yılında 15,4’e, </span></span></div> <div><span style="font-size: 12px;"><span style="color: rgb(20, 24, 35); background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">bebek ölüm hızı; 2002 yılında binde 31,5 iken </span></span></div> <div><span style="font-size: 12px;"><span style="color: rgb(20, 24, 35); background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">2012 yılında 7,4’e düşürülmüştür. </span></span></div> <div><span style="font-size: 12px;"> </span></div> <div><span style="color: rgb(255, 0, 0);"><strong><span style="font-size: 12px;"><span style="background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">Peki Bu Oranın Düşürülmesi İçin Ne Yapılmalı?</span></span></strong></span></div> <div><span style="font-size: 12px;"> </span></div> <div><span style="font-size: 12px;"><span style="color: red; background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">*</span><span style="background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">Her gebenin en az; 4 kez nitelikli izlenmesi, </span></span></div> <div><span style="font-size: 12px;"><span style="background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">doğum sonrası hastanede 3, evde 3 olmak üzere 6 kez lohusa izleminin yapılması, </span></span></div> <div><span style="font-size: 12px;"><span style="color: red; background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">*</span><span style="background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">Normal doğum sonrası 24 saat, sezaryen sonrası 48 saat hastanede takip edilmesi, </span></span></div> <div><span style="font-size: 12px;"><span style="color: red; background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">*</span><span style="background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">Her doğumun hastanede gerçekleştirilmesi</span></span></div> <div><span style="font-size: 12px;"> </span></div> <div><span style="color: rgb(255, 0, 0);"><strong><span style="font-size: 12px;"><span style="background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">Gebelikte Riskli Durumlar</span></span></strong></span></div> <div><span style="font-size: 12px;"> <img src="https://fbcdn-sphotos-d-a.akamaihd.net/hphotos-ak-xfp1/v/t1.0-9/11079661_1419214828383136_4841305370305028618_n.jpg?oh=1a363ae6c37652289115f33f63ab81ca&oe=55AF676B&__gda__=1437463867_80b32cc2afceec9ad1ee1b8a5ad6490c" width="500" height="333" alt="" /></span></div> <div><span style="font-size: 12px;"><span style="color: red; background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">*</span><span style="background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">Aile öyküsünde kalıtsal hastalıkların (konjenital hastalıklar,,kas hastalıklar, metabolik hastalıklar, endokrin hastalıkları, psikiyatrik hastalıklar vb.) varlığı. </span></span></div> <div><span style="font-size: 12px;"><span style="color: red; background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">*</span><span style="background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">Madde bağımlılığı (sigara, alkol, uyuşturucu) ,Toprak vb. yeme </span></span></div> <div><span style="font-size: 12px;"><span style="color: red; background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">*</span><span style="background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">Kronik sistemik hastalıklar (diabetes mellitus, hipertansiyon, kardiyovasküler hastalıklar, böbrek hastalığı, epilepsi, tiroid hastalıkları vb.) Sürekli kullanmak zorunda olduğu ilaçlar (antiepileptikler, antidiyabetikler, antihipertansifler vb.) </span></span></div> <div><span style="font-size: 12px;"><span style="color: red; background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">*</span><span style="background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">Geçirilmiş veya tedavisi sürmekte olan enfeksiyon hastalıkları (tüberküloz, brucella, paraziter hastaliklar, vb.) Cinsel yolla bulaşan enfeksiyon (CYBE) öyküsü </span></span></div> <div><span style="font-size: 12px;"><span style="color: red; background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">*</span><span style="background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">Psikiyatrik hastalıklar</span></span></div> <div><span style="font-size: 12px;"><span style="color: red; background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">*</span><span style="background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">Talesimili taşıyıcılığı</span></span></div> <div><span style="font-size: 12px;"><span style="color: red; background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">*</span><span style="background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">Geçirilmiş operasyonlar, jinekolojik operasyonlar (histerotomi, myomektomi vb.) </span></span></div> <div><span style="font-size: 12px;"><span style="color: red; background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">*</span><span style="background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">ilaç allerjisi </span></span></div> <div><span style="font-size: 12px;"> </span></div> <div><span style="color: rgb(255, 0, 0);"><strong><span style="font-size: 12px;"><span style="background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">Gebelikte Tehlike İşaretleri</span></span></strong></span></div> <div><span style="font-size: 12px;"> </span></div> <div><span style="font-size: 12px;"><span style="color: red; background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">*</span><span style="background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">Vajinal kanama </span></span></div> <div><span style="font-size: 12px;"><span style="color: red; background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">*</span><span style="background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">Konvülziyon (sara nöbeti gibi kasılmalar) </span></span></div> <div><span style="font-size: 12px;"><span style="color: red; background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">*</span><span style="background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">Başağrısı ile beraber görmede bozulma </span></span></div> <div><span style="font-size: 12px;"><span style="color: red; background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">*</span><span style="background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">Ateş </span></span></div> <div><span style="font-size: 12px;"><span style="color: red; background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">*</span><span style="background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">Günlük aktivitelerini yerine getirememe </span></span></div> <div><span style="font-size: 12px;"><span style="color: red; background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">*</span><span style="background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">Karın ağrısı </span></span></div> <div><span style="font-size: 12px;"><span style="color: red; background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">*</span><span style="background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">Solunum güçlüğü veya sık solunum </span></span></div> <div><span style="font-size: 12px;"><span style="color: red; background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">*</span><span style="background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">Suyunun gelmesi </span></span></div> <div><span style="font-size: 12px;"><span style="color: red; background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">*</span><span style="background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">Yüz, el ve bacaklarda </span><span style="background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">ş</span><span style="background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">i</span><span style="background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">şme </span></span></div> <div><span style="font-size: 12px;"> </span></div> <div><span style="color: rgb(255, 0, 0);"><strong><span style="font-size: 12px;"><span style="background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">Gebelik ve Kalp Hastalığı</span></span></strong></span></div> <div><span style="color: rgb(255, 0, 0);"><strong><span style="font-size: 12px;"> </span></strong></span></div> <div><span style="font-size: 12px;"><span style="color: red; background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">*</span><span style="background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">Bilinen veya kuşkulanılan, doğuştan veya edinilmiş kalp damar hastalığı olan her kadın gebe kalmadan önce risk değerlendirmesinden geçirilmeli ve danışmanlık hizmeti almalıdır. </span></span></div> <div><span style="font-size: 12px;"><span style="color: red; background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">*</span><span style="background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">Önemli kalp hastalığı olan kadınlar, perinatoloji uzmanı ve kardiyolog tarafından ortaklaşa izlenmelidir. </span></span></div> <div><span style="font-size: 12px;"><span style="color: red; background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">*</span><span style="background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">Gebe kalmayı planlayan hastaların fonksiyonel kapasitesi, muayene bulguları, istirahat elektrokardiyogramı, ekokardiyografisi değerlendirilmelidir. </span></span></div> <div><span style="font-size: 12px;"><span style="color: red; background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">*</span><span style="background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">Bilinen kalp hastalığı nedeni ile ilaç kullanan kadınlarda, gebelik sırasında hangi ilaçların sakıncalı olduğu, kesilmesi ve/veya değiştirilmesi gerektiği önceden belirlenmeli, gerekli ise başka tedavi seçeneklerin kullanılabilmesi için gebe kalınmadan önce bir risk değerlendirmesi yapılmalı ve tedavi gözden geçirilmelidir. </span></span></div> <div><span style="font-size: 12px;"><span style="color: red; background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">*</span><span style="background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">Gebeliğin ilerleyen evrelerinde hemodinamik sorunlar görülebileceği açıklanmalı, hasta ile (ve mümkünse eşiyle) izlem planı tartışılmalıdır. </span></span></div> <div><span style="font-size: 12px;"> </span></div> <div><span style="color: rgb(255, 0, 0);"><strong><span style="font-size: 12px;"><span style="background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">Gebelik ve Epilepsi</span></span></strong></span><span style="font-size: 12px;"><span style="color: red; background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;"><br /> <br type="_moz" /> </span></span></div> <div><span style="font-size: 12px;"><span style="color: red; background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">*</span><span style="background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">Gebelik öncesi, nöroloji uzmanı ile kadın hastalıkları ve doğum uzmanından mutlaka görüş alınarak gebelik öncesi, sırası ve sonrasındaki takipleri de bu bölümler tarafından yapılmalıdır. </span></span></div> <div><span style="font-size: 12px;"><span style="color: red; background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">*</span><span style="background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">Gebelik mutlaka planlı olmalıdır. ilaç değişim programları hasta gebe kalmadan en az 6 ay önce tamamlanmalıdır. </span></span></div> <div><span style="font-size: 12px;"><b><span style="color: red; background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">*</span><span style="background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">Monoterapi </span></b><span style="background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">tercih edilmeli ve anti epileptik ilaç mümkün olan <b>en az dozda </b>önerilmelidir. </span></span></div> <div><span style="font-size: 12px;"><span style="color: red; background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">*</span><span style="background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">Gebe kalmadan 3 ay önce bebekte oluşabilecek malformasyonları en aza indirgemek için günde 400 mcg folik asit desteği başlanmalı ve gebeliğin 10. haftasının sonuna kadar sürdürülmelidir. </span></span></div> <div><span style="font-size: 12px;"><span style="color: red; background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">*</span><span style="background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">Antiepileptik ilaç mutlaka nöroloji uzmanı tarafından düzenlenmelidir. Nöroloji uzmanına danışılmadan ilaç dozu ve etken maddesi değilştirilmemelidir. </span></span></div> <div><span style="font-size: 12px;"> </span></div> <div><span style="color: rgb(255, 0, 0);"><strong><span style="font-size: 12px;"><span style="background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">Doğum Sonu Bakım</span></span></strong></span><span style="font-size: 12px;"><span style="color: red; background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;"><br /> <br type="_moz" /> </span></span></div> <div><span style="font-size: 12px;"><span style="color: red; background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">*</span><span style="background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">Doğum Sonu Bakım Yönetim Rehberine uygun izlenmelidir. </span></span></div> <div><span style="font-size: 12px;"><span style="color: red; background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">*</span><span style="background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">İlaç kullanılmasına rağmen emzirmeye devam edilmelidir. </span></span></div> <div><span style="font-size: 12px;"><span style="color: red; background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">*</span><span style="background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">Loğusa doğum sonu 1.-3. haftada ilaç ve doz değişikliği için nöroloji uzmanı tarafından görülmelidir</span></span></div> <div><span style="font-size: 12px;"> </span></div> <div><span style="color: rgb(255, 0, 0);"><strong><span style="font-size: 12px;"><span style="background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">Gebelik ve Astım</span></span></strong></span><span style="font-size: 12px;"><span style="color: red; background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;"><br /> <br type="_moz" /> </span></span></div> <div><span style="font-size: 12px;"><span style="background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">Gebelik sırasında astımlı gebe için astım ilaçlarını kullanmak bu tedaviyi almadığında gelişecek olan kontrolsüz astım ve atakların yaratacağı risklerle karşılaştırıldığında çok daha güvenlidir</span></span></div> <div><span style="font-size: 12px;"> </span></div> <div><strong><span style="font-size: 12px;"> </span><span style="font-size: 12px;"><span style="background-image: initial; background-attachment: initial; background-size: initial; background-origin: initial; background-clip: initial; background-position: initial; background-repeat: initial;">Kaynak:İstanbul Times Haber Ajansı(İTHA)</span></span></strong></div> <div><span style="font-size: 12px;"> </span></div> <div><span style="font-size: 12px;"> </span></div> <div><span style="font-size: 12px;"> </span></div> <div><span style="font-size: 12px;"> </span></div> <div><span style="font-size: 12px;"> </span></div> <div><span style="font-size: 12px;"><b> </b></span></div> <div><span style="font-size: 12px;"> </span></div> <div><span style="font-size: 12px;"> </span></div> <div><span style="font-size: 12px;"> </span></div>